Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask / 生物医学工程学杂志

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO

Evaluation of microcirculatory changes after bundle therapy and prognostic value by the ratio of transcutaneous oxygen pressure and transcutaneous carbon dioxide pressure in the treatment of septic shock / 中华危重病急救医学

Objective@#To evaluate microcirculatory changes after bundle therapy and prognostic values of the ratio of transcutaneous oxygen pressure and transcutaneous carbon dioxide pressure (PtcO2/PtcCO2) in the treatment of septic shock.@*Methods@#A retrospective analysis was conducted. Patients with septic shock admitted to department of intensive care unit (ICU) of Northern Jiangsu People's Hospital from July 2017 to February 2019 were enrolled. The gender, age, infection site, acute physiology and chronic health evaluationⅡ (APACHEⅡ), the length of ICU stay and 28-day prognosis were collected; PtcCO2, PtcO2, PtcO2/PtcCO2 ratio, arterial lactate (Lac), central venous oxygen saturation (ScvO2), mean arterial pressure (MAP) were measured before treatment (at admission) and 6 hours after bundle treatment. According to the 28-day prognosis, the patients were divided into survival group and death group, and the differences of each index between the two groups were compared. The risk factors of prognosis were analyzed by binary Logistic regression analysis. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of the related indicators for the 28-day mortality of septic shock patients.@*Results@#A total of 78 patients with septic shock were enrolled, with 47 cases in survival group and 31 cases in death group. Compared with survival group, APACHEⅡ score and PtcCO2 were higher and PtcO2/PtcCO2 ratio was lower in death group [APACHEⅡ: 28.33±6.35 vs. 21.61±6.64, PtcCO2 (mmHg, 1 mmHg = 0.133 kPa): 51.80±19.05 vs. 38.17±6.79, PtcO2/PtcCO2 ratio: 1.20±0.72 vs. 1.80±0.81, all P < 0.05]. Compared with before treatment, the PtcO2/PtcCO2 ratio, Lac, MAP were substantially improved at 6 hours of bundle therapy [PtcO2/PtcCO2 ratio: 1.76±0.81 vs. 1.56±0.82, Lac (mmol/L): 3.74±2.40 vs. 4.42±2.60, MAP (mmHg): 83.34±7.58 vs. 71.00±5.36, all P < 0.05], and there was no changes in PtcCO2 and ScvO2. The PtcO2/PtcCO2 ratio at 6 hours of bundle therapy in the survival group was significantly higher than before treatment and was higher than that in death group (2.13±0.75 vs. 1.80±0.81, 1.19±0.53, both P < 0.05). There was no significant difference in PtcO2/PtcCO2 ratio of death group before and after treatment (1.19±0.53 vs. 1.20±0.72, P > 0.05). The binary Logistic regression showed that PtcO2/PtcCO2 ratio at 6 hours of bundle therapy and APACHEⅡ score were risk factors of prognosis [PtcO2/PtcCO2 ratio: odds ratio (OR) = 7.876, P = 0.026; APACHEⅡ score: OR = 0.846, P = 0.035]. ROC curve analysis showed that 6-hour of PtcO2/PtcCO2 ratio, APACHEⅡscore and 6-hour Lac level could predict 28-day mortality in septic shock patients, and the area under curve (AUC) was 0.864, 0.784, and 0.752 respectively. The cut-off value of 6-hour PtcO2/PtcCO2 ratio for predicting mortality in septic shock patients was 1.42, the sensitivity was 87.0%, and the specificity was 73.3%. In addition, the patients were divided into two groups according to whether the 6-hour PtcO2/PtcCO2 ratio was greater than 1.42. The results showed that: compared with the PtcO2/PtcCO2 < 1.42 group, the APACHEⅡ score in PtcO2/PtcCO2 ≥ 1.42 group was lower, the 6-hour Lac level was lower, 24-hour Lac reaching standard rate was higher and the 28-day mortality was lower.@*Conclusions@#Compared with the traditional metabolic parameters, the improvement of early microcirculatory perfusion in patients with septic shock can reflect the effect of bundle therapy. The PtcO2/PtcCO2 ratio at 6 hours of bundle therapy can be used as a new index to predict the prognosis of patients with septic shock which supports the monitoring and evaluation of microcirculation in the early stage of treatment in septic shock.

The value of renal resistance index and urine oxygen pressure for prediction of acute kidney injury in patients with septic shock / 中华内科杂志

Objective To explore the value of renal resistance index (RI) and urine oxygen pressure for early prediction of acute kidney injury (AKI) in patients with septic shock.Methods Patients with septic shock were enrolled from August 2018 to November 2018 in intensive care unit (ICU) at Peking Union Medical College Hospital.Subjects' general information and AKI characteristics were assessed.Area under the receiver operating characteristic (ROC) curve was used to analyze the predictive value of RI,urine oxygen pressure,or combination of RI on the occurrence of AKI.Results A total of 72 septic shock patients were enrolled including 29 patients with AKI and 43 without.Logistic regression analysis of AKI risk factors found that RI (OR=1.139,95％CI 1.029-1.261,P=0.012) and urine oxygen pressure (OR=0.957,95％CI 0.923-0.991,P=0.014) at admission were independent risk factors for AKI in patients with septic shock.The sensitivity and specificity of dual RI and urine oxygen pressure in predicting AKI were 65.5％and 76.7％ respectively (AUCROC 0.772,Youden index 0.423).We selected the cut-off value of RI as 0.70,and urine oxygen pressure as 48 mmHg (1 mmHg=0.133 kPa).According to this two cut-off values patients were divided into four groups,those with RI≥0.70 and urine oxygen pressure≤48 mmHg showed the highest incidence of AKI (75％).There was no statistically difference in 28-day survival rate between the four groups (P=0.197).Conclusion High RI and low urine oxygen pressure are independent risk factors for the development of AKI in patients with septic shock.The predictive cut-off values are 0.70 for RI and 48 mmHg for urine oxygen pressure.Combination of RI and urine oxygen pressure has a practical predictive value for AKI in patients with septic shock.

Evaluation of microcirculatory changes after bundle therapy and prognostic value by the ratio of transcutaneous oxygen pressure and transcutaneous carbon dioxide pressure in the treatment of septic shock / 中华危重病急救医学

Objective To evaluate microcirculatory changes after bundle therapy and prognostic values of the ratio of transcutaneous oxygen pressure and transcutaneous carbon dioxide pressure (PtcO2/PtcCO2) in the treatment of septic shock. Methods A retrospective analysis was conducted. Patients with septic shock admitted to department of intensive care unit (ICU) of Northern Jiangsu People's Hospital from July 2017 to February 2019 were enrolled. The gender, age, infection site, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), the length of ICU stay and 28-day prognosis were collected; PtcCO2, PtcO2, PtcO2/PtcCO2 ratio, arterial lactate (Lac), central venous oxygen saturation (ScvO2), mean arterial pressure (MAP) were measured before treatment (at admission) and 6 hours after bundle treatment. According to the 28-day prognosis, the patients were divided into survival group and death group, and the differences of each index between the two groups were compared. The risk factors of prognosis were analyzed by binaryLogistic regression analysis. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of the related indicators for the 28-day mortality of septic shock patients. Results A total of 78 patients with septic shock were enrolled, with 47 cases in survival group and 31 cases in death group. Compared with survival group, APACHEⅡ score and PtcCO2 were higher and PtcO2/PtcCO2 ratio was lower in death group [APACHEⅡ:28.33±6.35 vs. 21.61±6.64, PtcCO2 (mmHg, 1 mmHg = 0.133 kPa): 51.80±19.05 vs. 38.17±6.79, PtcO2/PtcCO2 ratio: 1.20±0.72 vs. 1.80±0.81, all P < 0.05]. Compared with before treatment, the PtcO2/PtcCO2 ratio, Lac, MAP were substantially improved at 6 hours of bundle therapy [PtcO2/PtcCO2 ratio: 1.76±0.81 vs. 1.56±0.82, Lac (mmol/L):3.74±2.40 vs. 4.42±2.60, MAP (mmHg): 83.34±7.58 vs. 71.00±5.36, all P < 0.05], and there was no changes in PtcCO2 and ScvO2. The PtcO2/PtcCO2 ratio at 6 hours of bundle therapy in the survival group was significantly higher than before treatment and was higher than that in death group (2.13±0.75 vs. 1.80±0.81, 1.19±0.53, both P < 0.05). There was no significant difference in PtcO2/PtcCO2 ratio of death group before and after treatment (1.19±0.53 vs. 1.20±0.72, P > 0.05). The binary Logistic regression showed that PtcO2/PtcCO2 ratio at 6 hours of bundle therapy and APACHEⅡ score were risk factors of prognosis [PtcO2/PtcCO2 ratio: odds ratio (OR) = 7.876, P = 0.026; APACHEⅡscore: OR = 0.846, P = 0.035]. ROC curve analysis showed that 6-hour of PtcO2/PtcCO2 ratio, APACHEⅡscore and 6-hour Lac level could predict 28-day mortality in septic shock patients, and the area under curve (AUC) was 0.864, 0.784, and 0.752 respectively. The cut-off value of 6-hour PtcO2/PtcCO2 ratio for predicting mortality in septic shock patients was 1.42, the sensitivity was 87.0％, and the specificity was 73.3％. In addition, the patients were divided into two groups according to whether the 6-hour PtcO2/PtcCO2 ratio was greater than 1.42. The results showed that: compared with the PtcO2/PtcCO2 < 1.42 group, the APACHEⅡ score in PtcO2/PtcCO2 ≥ 1.42 group was lower, the 6-hour Lac level was lower, 24-hour Lac reaching standard rate was higher and the 28-day mortality was lower. Conclusions Compared with the traditional metabolic parameters, the improvement of early microcirculatory perfusion in patients with septic shock can reflect the effect of bundle therapy. The PtcO2/PtcCO2 ratio at 6 hours of bundle therapy can be used as a new index to predict the prognosis of patients with septic shock which supports the monitoring and evaluation of microcirculation in the early stage of treatment in septic shock.

The value of transcutaneous oxygen pressure/transcutaneous carbon dioxide pressure monitoring in early warning of the observing patients in emergency department / 中国实用护理杂志

Objective To analyze the relevant factors of early warning in emergency patients with high risk of acute sores, explore the application value of transcutaneous oxygen pressure(TcPO2) and transcutaneous carbon dioxide pressure(TcPCO2)monitoring in the early warning of emergency patients with pressure ulcers. Methods This was a study of 186 consecutive emergency patients who were under care in the emergency department. The transcutaneous oxygen/carbon dioxide pressure monitor was used in monitoring the oxygen saturation of the skin of sacrococcygeal region and the chest. Meanwhile,the Braden scale was used in assessing risk factors for pressure ulcers and the receiver operating characteristic curve (ROC curve) was applied to evaluate the early prediction of pressure sore with TcPO 2/TcPCO2 monitor. Results Implementing the logistic regression model with six indicators, this research concluded that TcPO2 CV and PO2 were independent risk factors for the development of Braden scale in patients with high risk. The area under the ROC curve showed that TcPO2 CV had a excellent predictive value for the high-risk group and determined its cut-off value to be 20％. Which means patient with both a value of TcPO2CV over 20％ and a high risk of Braden scale had a larger possibility of pressure ulcers. Conclusions TcPO2 CV was an independent risk factor for patients under emergency care to develop pressure ulcers. A value of TcPO2CV over 20％indicated a high risk of pressure ulcers.

Correlation of transcutaneous oxygen pressure and blood lactate in patients with septic shock / 中华内科杂志

To analyze the correlation between transcutaneous oxygen pressure (PtcO2) and blood lactate in patients with septic shock. Fifty-sixpatients with septic shock were prospectively investigated. PtcO2 was monitored continuously for 6 hours, and arterial blood gas was measured at baseline (T0) and 6 hours (T6). Records of PtcO2, were analyzed for the correlation with lactate level and lactate clearance rate. PtcO2 valuesin the high lactate clearance group and the low one were compared.The lowest value of PtcO2 at T6 and duration of PtcO2<40 mmHg (1 mmHg=0.133 kPa) were both correlated with lactate level and lactate clearance rateat T6. The low predictive value of PtcO2 was 29 mmHg of lactate clearance under 20％with a sensitivity 85.2％and a specificity 65.5％. The low predictive value of PtcO2 in high lactate clearance group was significantly higher than that in low lactate clearance group, while the duration of PtcO2<40 mmHg was shorter than the latter. During 6 h continuous monitoring, patients with a significant low PtcO2 or prolonged duration of low PtcO2 have relatively high lactate or low lactate clearance after resuscitation.

Application of transcutaneous oxygen pressure in scar assessment / 中国修复重建外科杂志

Objective: To review the application and research progress of transcutaneous oxygen pressure (TcPO 2) in scar assessment. Methods: The original articles about scar and TcPO 2 were reviewed and analyzed. Results: Hypoxia environment plays an important role in the progression of scar tissue. TcPO 2 can accurately reflect the oxygen tension of scar tissue, which is of great significance in the assessment of scar maturity, the guidance of scar treatment, and the study of correlations between hypoxia and the progression of scar. Conclusion: TcPO 2 measurement is important in the study of scar evaluation, treatment, and correlation between hypoxia and scar formation.

Diagnóstico matemático de dinámica cardiaca en 16 horas y evaluación de variables hemodinámicas en la Unidad de Cuidados Intensivos / Mathematical diagnosis of cardiac dynamics in 16 hours and evaluation of hemodynamic variables in the Intensive Care Unit

Antecedentes: desde los sistemas dinámicos se desarrolló un diagnóstico de la dinámica cardiaca de aplicación clínica en 16 horas, de utilidad en pacientes de Unidad de Cuidados Intensivos. Objetivos: confirmar la capacidad diagnóstica de la nueva metodología de evaluación de la dinámica cardiaca en 16 horas y determinar la evolución de la presión arterial y venosa de oxígeno y dióxido de carbono. Metodología: se tomaron 50 dinámicas, 10 normales y 40 con patologías agudas, tomando la frecuencia cardiaca mínima y máxima, y número de latidos cada hora. Se construyeron atractores y se evaluaron los espacios de ocupación y la dimensión fractal en 21 y 16 horas, comparando ambos diagnósticos físico-matemáticos entre sí. Posteriormente se realizó una confirmación del diagnóstico establecido en 16 horas mediante un estudio ciego de comparación con el diagnóstico convencional. Adicionalmente se tomaron los valores de la presión arterial y venosa de oxígeno y dióxido de carbono de 7 pacientes de Unidad de Cuidados Intensivos y se construyeron atractores caóticos, evaluando los valores mínimos y máximos del atractor en el mapa de retardo. Resultados: se confirmó la capacidad diagnóstica de la metodología en 16 horas para la dinámica cardiaca, con sensibilidad y especificidad de 100 por ciento y coeficiente kappa de 1 respecto al diagnóstico convencional; los valores mínimos y máximos de los atractores de la presión arterial y venosa de oxígeno y dióxido de carbono se encontraron entre 29,60 y 194,40; 24,20 y 56,10; 16,40 y 65,60 y 21,40 y 97,90 respectivamente. Conclusiones: se confirmaron predicciones diagnósticas en 16 horas diferenciando normalidad, enfermedad crónica y enfermedad aguda, útiles para el seguimiento clínico en pacientes de Unidad de Cuidados Intensivos. Las variables se comportaron caóticamente; estos resultados podrían fundamentar aplicaciones clínicas y predicciones de mortalidad. Palabras claves: frecuencia cardiaca, presión arterial de oxígeno, presión arterial de dióxido de carbono, presión venosa de oxígeno, presión venosa de dióxido de carbono, Sistemas Dinámicos, caos, fractales, dinámica no lineal(AU)

Objectives: to confirm the diagnostic ability of the new assessment methodology of cardiac dynamics in 16 hours and determine the evolution of the arterial and venous pressure of oxygen and carbon dioxide. Methodology: 50 dynamic were taken, 10 normal and 40 with acute pathologies, taking the minimum and maximum heart rate, and number of beats per minute. Attractors were constructed and areas of occupation and the fractal dimension in 21 and 16 hours were evaluated, comparing both physical and mathematical diagnosis each other. Subsequently a confirmation of the diagnosis made in 16 hours by a blinded study compared to conventional diagnosis. Additionally, values of the arterial and venous pressure of oxygen and carbon dioxide from 7 Intensive Care Unit patients were taken and chaotic attractors were constructed to evaluate the minimum and maximum values of the attractor on the delay map. Results: The diagnostic capability of the methodology in 16 hours for cardiac dynamic was confirmed, with sensitivity and specificity of 100 percent and kappa coefficient 1 over conventional diagnosis; the minimum and maximum values of the arterial and venous pressure of oxygen and carbon dioxide were found between 29.60 and 194.40; 24.20 and 56.10; 16,40 and 65,60 and 21,40 and 97,90 respectively. Conclusions: Diagnostic predictions were confirmed in 16 hours differentiating normal, chronic and acute disease useful for clinical monitoring in Intensive Care Unit patients. The variables behaved chaotically; these results may inform clinical applications and predictions of mortality. Keywords: heart rate, arterial oxygen pressure, carbon dioxide arterial pressure, venous oxygen pressure, carbon dioxide venous pressure, dynamical systems, chaos, fractals, nonlinear dynamics(AU)

Transcutaneous oxygen pressure andits clinical significance in patients with type 2 diabetic peripheral neuropathy / 中国糖尿病杂志

Objective To evaluate the transcutaneous oxygen pressure (TcPO2 )and its clinical significance in patients with type 2 diabetic peripheral neuropathy (DPN). Methods A total of 222 hospitalized patients with type 2 diabetes mellitus (T2DM)from the Department of endocrinology of Lianyungang First People's Hospital in Jiangsu Province were enrolled in this study from October 2014 to September 2015.And 50 healthy controls were also selected in this study as control group (NC group). TcPO2 was tested in supine position in all the subjects by TCM400 TcPO2 detector. Patients with T2DM then were divided into two groups according to Nerve conduction velocity (NCV):DPN group (n = 102) and non-DPN group (NDPN group,n = 120).Anthropometric and metabolic parameters were assessed in each group. Results TcPO2 in supine positionwas lower in DPN group than in NC and NDPN group. TcPO2 was positively correlated with diabetes duration,TCSS scores,HbA1 c,SUA,FPG and NCV.Compared with normal TcPO2 group,the prevalence of DPN was increasedin low TcPO2 group,while NCV of motor nerve and sensory nerve were decreasedin low TcPO2 group.Logistic analysis showed that TcPO2 was an independent risk factor for DPN. Conclusion TcPO2 in supine position was decreased in patients with DPN,and is a risk factor for DPN,which may provides valuable information for DPN diagnosis.

The application of non-invasive transcutaneous monitoring of oxygen and carbon dioxide in newborns / 国际儿科学杂志

Non-invasive transcutaneous monitoring(TCM) of oxygen and carbon dioxide,with continuous,non-invasive characteristics,is in common use and significant in the neonatal intensive care unit (NICU),which can directly reflect critically ill newborns'changes of respiratory and circulatory function.This review describes how to use TCM appropriately,compares the advantages and disadvantages of TCM with other monitoring devices,introduces its application in neonatal transport and NICU.

Influencia de la variación de la presión de oxígeno ambiental en la formación ósea en cuyes nativos del nivel del mar / Influence of environmental oxygen pressure variation in sea level native guinea pigs bone formation

Introducción: La hipoxia caracteriza a los tejidos inicialmente injuriados; la variación en la disposición del oxígeno tisular en el proceso de reparación ósea determina la aparición de diversas moléculas implicadas en la sanación del tejido. Objetivos: Determinar si la variación de la presión de oxígeno ambiental influirá en la formación ósea posterior a una osteotomía en cuyes nativos del nivel del mar. Diseño: Experimental. Lugar: Facultad de Odontología de la Universidad Nacional Mayor de San Marcos, Lima, Perú, e Instituto Veterinario de Investigaciones Tropicales y de Altura, Mantaro, Perú. Material biológico: Cuyes. Intervenciones: Se utilizó 5 grupos de 10 cuyes cada uno, uno sin inducción de osteotomía (grupo control) y cuatro grupos experimentales: mar 15 días y mar 30 días (expuestos a PO2 ambiental de 157 mmHg), altura 15 días y altura 30 días (expuestos a PO2 ambiental de 107 mmHg). Principales medidas de resultados: Conteo de osteocitos. Resultados: El grupo mar 15 días presentó menor número de osteocitos comparado con el grupo altura 15 días (63 180 vs. 80 310, p<0,05). A su vez, el grupo mar 30 días presentó también menor número de osteocitos comparado con el grupo altura 30 días (160 640 vs. 167 370, p<0,05). Conclusión: La menor presión de oxígeno ambiental favoreció una mayor formación ósea en cuyes nativos del nivel mar...

Introduction: Hypoxia characterizes initially injured tissue; variation in oxygen available determines the appearance of molecules involved in bone repair. Objectives: To determine if environmental oxygen pressure variation influences bone formation following osteotomy in sea level native guinea pigs. Design: Experimental. Setting: Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru, and Tropical and High Altitude Research Veterinary Institute, Mantaro, Peru. Biological material: Guinea pigs. Interventions: Five groups of 10 guinea pigs each included one without osteotomy (control group) and four experimental groups: sea 15 days and sea 30 days (exposed to environmental PO2 157 mmHg), high altitude 15 days and high altitude 30 days (exposed to environmental PO2 107 mmHg). Main outcome measures: Osteocytes count. Results: The 15 days sea group had lower number of osteocytes compared with the 15 days high altitude group (63 180 vs. 80 310, p<0.05). The 30 days sea group had also lower number of osteocytes compared with the 30 days high altitude group (160 640 vs. 167 370, p<0.05). Conclusions: The lower environmental oxygen pressure favored higher bone formation in sea level native guinea pigs...

The effection of nitric oxide and suPeroxide dismutase in the human umbilical cord Wharton jelly mesenchyme cell transPlanted with hyPerbaric oxygen treated in myocardial infarction rats / 中国综合临床

Objective To explore whether hyperbaric oxyGen could improve microenvironment of transplanted stem cell in myocardial infarction rats or not. Methods Sixty-six SD rats were randomly divided into four Groups:sham operated,myocardial infarction( MI),Stem Cell Transplanted( SC),hiGh oxyGen pressure ( HBO)+SC Groups respectively. MI rat model was established,and then HBO treatment was carried out every day from the first day to 30th day. Human umbilical cord Wharton jelly mesenchyme cell was transplanted on the 7th day after MI. The serum level of superoxide dismutase( SOD ) and nitric oxide( NO ) were assayed respectively by xanthine oxidase method and nitric acid reduction colorimetric technique on the lst,7th,l4th and 30th day after MI. Human Whartonˊs jelly stem cells was marked with electronic display unit for tracinG in vivo. Stem cell proliferation and survival rate were identified by immunofluorescence method. Results ( l ) Compared with MI and SC Group respectively,the level of SOD increased siGnificantly in HBO +SC Group( P<0. 05).(2)Compared with MI Group,the level of NO increased siGnificantly in HBO+SC Group all time( P<0. 05),and compared with SC Group,the level of NO also increased siGnificantly at the l4th and 30th day( P<0. 05).(3)Compared with SC Group,the stem cell proliferation and survival rate all increased siGnificantly in HBO+SC Group at the l4th and 30th day(55. 00% vs 80. 58%,34. 28% vs 79. l2%,P<0. 05). Conclusion Stem cell transplanted assisted with hyperbaric oxyGenation could siGnificantly increase the level of NO and SOD,so as to improve the stress state after MI and promot the proliferation and survival rate of stem cell.

Effects of Low Frequency Sound Waves of Different Timbres on Weizhong Microcirculation and Transcutaneous Oxygen Partial Pressure of Healthy People / 中国中医药信息杂志

Objective To discuss different effects of low frequency sound waves of different timbres on microcirculation and transcutaneous oxygen partial pressure of Weizhong (BL40) of healthy people;To study the mechanism of somatosensory music therapy. Methods The same frequency (98.00 Hz), different timbres (sounds of guqin, flute, ocarina, bell, and drum were simulated) low frequency sound waves were played near Weizhong acupoint of 30 healthy persons. Laser Doppler flowmetry was used to analyze microcirculation and the changes of transcutaneous oxygen pressure of meridian acupoints, when each timbre was played for 60, 120, 180, 240 and 300 s. Results Sound waves of bell, drum, and flute made point microcirculation and transcutaneous oxygen pressure gradually increase, and the influence of drum>bell>flute;timbre waves of ocarina and guqin made the point microcirculation and transcutaneous oxygen pressure decrease gradually decrease, and the decrease of ocarina was more significant than that of guqin. In the same time point, sound waves of bell made point microcirculation and transcutaneous oxygen pressure increase more than the other sound waves (P<0.01). Conclusion Low frequency sounds of different timbres belong to different properties of five elements. They have different components in frequency spectrum, and can create different effects on acupoints.

The changes of arterial partial pressure of oxygen and blood lactate level in patients with cardiopulmonary resuscitation and its clinical significance / 中国基层医药

Objective To explore the relation between the level of oxygen pressure and lactate in arterial blood and prognosis of cardiopulmonary resuscitation (CPR).Methods 36 patients with sudden cardiac arrest received CPR were selected.Patients were divided into 3 groups.The 21 patients who 30 minutes of CPR didn't regain heart beats were group A,those 10 who kept blood circulation for over 2 hours but finally died were group B,and the remaining 5 who survived were group C.Control group was made up of 20 people with no disease.In CPR immediately (0h),1h,3h,6h,12h were measured in blood specimens from arterial partial pressure of oxygen and lactate levels were compared among groups of patients dynamic changes of the index.Results The 3 groups A,B,C significantly reduced blood oxygen pressure,blood lactate increased significantly the CPR in the early,and compared with the control group there was significant difference( P ＜ 0.01 ).The group B CPR 3h,6h,and continue until no significant changes in 12h;The group C CPR 3h,6h began to increase blood oxygen pressure and blood lactate levels begin to decline,blood oxygen pressure increased significantly,lower blood lactate to a lower level after 12h.Taken with marked changes in B group,the difference was significant ( P ＜ 0.05 ).Conclusion Arterial partial pressure of oxygen and blood lactate levels could be used as indicators of prognosis of patients with CPR.Sustained increase in arterial oxygen partial pressure showed a good prognosis,lactate levels continued to rise that a poor prognosis.

Autologous bone marrow-mononuclear cell transplantation after the bone marrow stimulation in the treatment of thromboangiitis obliterans / 中国综合临床

Objective To investigate the effect and safety of autologons bone margow-mononuclear cell (BM-MNC)transplantation after the bone marrow stimulation in patients with thromboangiitis obliterans (TAO).Methods The bone marrows of 12 patients were stimulated by an injection of the recombinant human granuloeyte-macmphage colony-stimulatory factor(GCSF)for 3-5 days.150-200 ml bone marrow was drown from the iliac spine and the autologous BM-MNC were obtained in each patients.Fifteen lower limbs of 12 patients received implantation of the autologous BM-MNC by an intramuscular iniecdon.A series of subjective indexes(including improvement of pain and cold sensation)and objeetive indexes [including increase of ankle braehial index(ABI),transcutaneons oxygen pressure(TcPO2)and improvement of foot skin ulcer] were used to evaluate the effects.Results The outcomes were evaluated after 2 months of transplantation.The pain-relief rate and the cold feeling improvement rate were 86.7%(13/15)and 93.3%(14/15)respectively.The ABI were 0.38 ±0.05 vs.0.61 ±0.14(P<0.05)before transplantation and 2 months after transplantation respectively.increased in 66.7%(10/15)limbs.The TcPO2 of the ischemic legs increased from(27.47±2.85)mm Hg to(43.53 ±8.38)mm Hg(t=-7.03,P<0.05)after the transplantation,and the improvement rate of TcPO2 was 93.3%(14/15).Skin ulcers in improved in 8/9 limbs.Twelve patients were followed up for all average period of 10 months.The patients'symptoms improved in 80.0%(12/15)limbs,as to the objective index the ABI was0.57±0.13,TcPO2 was(42.07 ±7.81)mm Hg,which improved significandy compared to before treatment(t=-5.33,-7.80,Ps<0.05).skin ulcer healing rate was 66.7%(6/9).The ischemic symptoms in 2 patients were not relieved.There WBS no mortality and high level amputation in all subjects.The complications,such as proliferative retinopathy,malitpmnt tumor,myocardial infarction,stroke or hemangioma were not found in any patients.Conclusion In patients with TAO,intramuscular transplantation of autologous BM-MNC after the bone marrow stimulation has advantages of less bone marrow aspiration,more mononuclear cell content and relatively high safety.It may be a new and effective method to alleviate symptoms and accelerate the healing of skin ulcer.

The Usefulness of Transcutaneous Tissue Oxygen Pressure (TcpO2) for Determination of the Point of Time at Venous Revascularization

PURPOSE: The purpose of this study is to delineate the optimal time of venous revascularization for preventing the flap necrosis due to venous occlusion, and to clarify the usefulness of tissue oxygen pressure (TcpO2) in the determination of the point of time for venous revascularization. METHODS: Thirty-six, 3 x 3 cm sized epigastric island flap was elevated in left abdomen of male Sprague-Dawley rat weighing 250 gram. Flaps were randomly assigned to six groups of six flaps according to the duration of venous occlusion with microvascular clamp; 10 minutes in the group I as the control, 60 minutes in the group II, 2 hours in the group III, 3 hours in the group IV, 4 hours in the group V, and 6 hours in the group VI, respectively. Just before removal of clamp after flap was reposed in situ, the ratio of TcpO2 (tissue oxygen pressure) of the island flap to that of right abdomen was calculated in each group, and tissue specimen was harvested from the distal area of the flap for histological evaluation of vascular change. Five days later, survival area of the flap was estimated, and evaluated the correlation between the tissue oxygen pressure and the rate of flap survival. RESULTS: The TcpO2 and the survival rate of flap were decreased proportionally with the duration of venous occlusion. The ratio of the TcpO2 of the flap is decreased abruptly to below sixty percentile compared to the TcpO2 of normal tissue, and the survived area of the flap is decreased to nine-tenth of the designed size after three hours of total venous occlusion. Histologically, the number of congested vessels was increased according to venous occluded time, and proportionally increased after 3-hours of occlusion significantly. CONCLUSION: There is a close correlation between the TcpO2 and the survival rate of flaps according to the duration of venous occlusion. Therefore, the TcpO2 represents the hemodynamic changes within the flap, and thought to be an alternative effective tool in the flap monitoring for venous revascularization.

Effect of hemodilution on brain tissue oxygen pressure and prognosis in patients with severe craniocerebral trauma / 中华创伤杂志

Objective To discuss the effect of hemodilution on brain tissue oxygen pressure and prognosis in patients with severe craniocerebral trauma. Methods A total of 42 cases of severe craniocerebral trauma were randomized divided into two groups, ie, control group and treatment group, to observe the changes of brain tissue oxygen pressure ( PbtO2 ) , hematocrit (HCT) and 6-month Glasgow outcome scale (COS) after injury. Then, PbtO2, HCT and GOS were compared between two groups. Restilts ( 1 ) There was a positive correlation between PbtO2 and HCT when HCT was lower than 0.25( r =0. 732 ,P ＜0. 001 ) in the treatment group; while a negative correlation was found between PbtO2 and HCT when HCT was higher than 0.25(r = - 0. 698 ,P＜0. 001 ). (2) Compared with control group, the index of brain tissue oxygen in treatment group was obviously higher ( t = 2.27, P = 0. 029 ) , with better prognosis (X2= 5.09, P ＜ 0.05 ). Conclusion Hemodilution can significantly increase brain tissue oxygen supply and improve the prognosis of cases of severe craniocerebral trauma.

Study of acute lung Injury in rats with acute carbon monoxid poisoning(ACOP) / 中华急诊医学杂志

Objective To structure the model of acute carbon monoxid poisoning(ACOP)in rats. Evaluate the effectiveness of the poisoning on the pulmonary function and the significance of carbon monoxide hemoglobin(HbCO)and oxygenation index in diagnosis of acute lung injury(ALI)/acute respiratory distress syndrome(ARDS).Method Eighty healthy adult male Wistar rats were randomized into 4 groups.According to the concentration of CO,poisoning group was randomized into three groups(each group=20),group A,group B,group C.After poisoned,arterial blood was collected rapidly for arterial blood gas analysis.According to the pathological changes,the models were divided into ALI/ARDS group and non-ALI/ARDS group.Results Compared with control group,the incident rate of ALI/ARDS in group B(25%)and group C(55%)were significantly higher(P

Decrease in Arterial Oxygen Partial Pressure by Pleural Opening in Thoracotomy during One-Lung Ventilation / 대한마취과학회지

BACKGROUND: One-lung ventilation (OLV) is commonly used in the majority of thoracotomies and thoracoscopic surgeries. During OLV, a decrease in partial pressure of arterial oxygen (PaO2) occurs due to the right-to-left transpulmonary shunt that develops in the non-dependent lung, and is aggravated just after pleural opening. Here, we examined the occurrence, cause, and means of preventing drops in PaO2 caused by pleural opening. METHODS: Seventy patients, ASA PS I or II, who were scheduled for elective thoracotomy or thoracoscopic surgery, were prospectively examined. After OLV, patients were randomly allocated to one of four groups. In the Control group (n = 10), pleurae were not opened during studies. In the Open group (n = 20), pleurae were opened with the plug of the double-lumen endobronchial tube of the non-dependent lung opened. In the Closure group (n = 20), the plug was closed just before pleural opening. And in the continuous positive airway pressure (CPAP) group (n = 20), pleurae were opened after applying 5 cmH2O CPAP of medical air to the non-dependent lung. Arterial blood gas analyses, hemodynamics, end-tidal CO2, peak inspiratory airway pressure, lung compliance, and airway resistance were recorded 15 min after two-lung ventilation, 20 min after transition to OLV, just before pleural opening, and 1, 3, and 20 min after pleural opening. In the control group, data were recorded 15 min after two-lung ventilation and in seven intervals after transition to OLV (1, 3, 5, 10, 20, 25, and 45 min). RESULTS: A significant decrease in PaO2 was detected just after pleural opening in the Open and Closure groups. PaO2 decreased in the Open group more than in the Closure group. However, in the CPAP group, no significant PaO2 reduction was detected after pleural opening. CONCLUSIONS: We found that PaO2 decreased when pleurae were opened during OLV. This may be due to the sudden development of atelectasis in the non-dependent lung by exposure to atmospheric pressure. This decrease in PaO2 can be relieved by closing the double-lumen endobronchial tube's plug of the non-dependent lung or by applying CPAP to the non-dependent lung when pleurae are opened.

Application of continuous monitoring of jugular venous oxygen saturation in the course of mild hypothermia treatment of severe traumatic brain injury / 中华创伤杂志

Objective To discuss significance of continuous monitoring of jugular venous oxygen saturation(S_(jv)O_2)in the course of mild hypothermia treatment(MHT)for severe traumatic brain injury (sTBI).Methods Intracranial pressure(ICP),S_(jv)O_2 and brain tissue pressure(P_(bt)O_2)were contin- uously monitored in 36 cases with sTBI for analyzing the correlation between S_(jv)O_2 and P_(bt)O_2.Results (1)There was negative linear correlation between P_(bt)O_2 and ICP(r=-0.978,P＜0.05),negative lin- ear correlation between S_(jv)O_2 and ICP(r=-0.947,P＜0.05)and positive linear correlation between P_(bt)O_2 and S_(jv)O_2(r=0.965,P＜0.05)within 24 hours and at 36 hours and 48 hours after injury.(2) The cases with decreased S_(jv)O_2 value had a worse outcome than those with normal S_(jv)O_2.meanwhile,the cases with abnormal increase of S_(jv)O_2 value had worse prognosis.Prognnsis was improved significantly with increase of S_(jv)O_2 in certain range(P＜0.05).Conclusion Continuous monitoring of S_(jv)O_2 can reflect the condition of hemicerebral oxygen metabolism and guide treatment and predicting outcome.